BACKGROUND:
The effects of omega-3 fatty acids (PUFA) on the prevention of atrial fibrillation (AF) appear to contrast between several randomized controlled trials (RCTs). Therefore, we performed a meta-analysis to assess the efficacy and safety of PUFA for the primary and secondary prevention of AF.

METHODS:
PubMed, EMBASE, Web of Science, Cochrane Library and the Chinese Biomedical Literature Database were searched for randomized controlled trials (published up to January 2012) that compared PUFA with control. All statistical analyses were performed with RevMan (version 5.1; The Cochrane Collaboration, Oxford, United Kingdom).

RESULTS:
For primary prevention after open heart surgery: 6 studies with 928 patients were designed to evaluate the effects of PUFA on the incidence of postoperative AF. The use of PUFA significantly reduced the incidence of postoperative AF (odds ratio [OR] 0.66; 95% confidence interval [CI], 0.49 to 0.88; P = 0.004); there was no difference in complications or adverse events (OR, 1.24; 95% CI, 0.58-2.62; P = 0.58). For secondary prevention, we analyzed 5 studies involving 1256 patients designed to evaluate the effects of PUFA therapy on AF. The use of PUFA did not significantly reduce the recurrence of AF (OR, 0.74; 95% CI, 0.39-1.42; P = 0.37); no difference was observed in complications or adverse events (OR, 1.10; 95% CI, 0.78-1.57; P = 0.58).

CONCLUSIONS:
The meta-analysis shows that PUFA therapy is significantly associated with a decreased odds of incidence of AF after open heart surgery, but there is no significant difference in recurrence of AF between PUFA and control groups. PUFA is well-tolerated, with no difference in complications or adverse events between PUFA and control groups.